AB0216 FATIGUE ASSESSMENT IN RHEUMATOID ARTHRITIS, SANTO DOMINGO, DOMINICAN REPUBLIC
Authors: R. A. Alvarez Santana, D. Garcia, J. Santana Peralta, A. Cornelio, L. Concepción Sanchez, T. Polanco Mora, I. Paulino, I. Mercedes, E. Rodriguez Bautista, T. Valdez, A. Feriz, R. Muñoz Louis
Journal: Annals of the Rheumatic Diseases (2022)

Background Rheumatoid arthritis (RA) is an inflammatory, systemic autoimmune disease affecting the synovial membrane of small joints. 1 Wagan A. et al demonstrated that the frequency of fatigue in rheumatoid arthritis is 62%, 2 Hammam et al described a higher rate of fatigue associated with higher disease activity. Fatigue is as a feeling of exhaustion, also as a reduction in physical and mental capacity, 3,4 it can be measured with the scale FACIT-F (Functional Assessment of Chronic Illness Therapy-Fatigue), which evaluates the last 7 days, with a score of 0-52. For the severity analysis, 4 grades are used: no or mild fatigue (40-52), moderate (27-39), severe (14-26) and extreme fatigue (0-13). 2,5 Objectives To evaluate the frequency and degree of fatigue in rheumatoid arthritis. Methods Prospective, observational, cross-sectional study of a cohort of patients of the Rheumatology Service of the Hospital Docente Padre Billini. Patients were interviewed in July 2021. Inclusion criteria: ≥ 18 years, diagnosis of RA according to the ACR/EULAR 2010 classification criteria. Exclusion criteria: previous diagnosis of fibromyalgia, depression or anxiety, treatment with antidepressants, antihistamines, beta-blockers. Scales measured: FACIT-F, DAS28, CDAI, and HAQ-DI. Statistical analysis was performed with the Pearson correlation ( r p ). Data were analyzed in IBM-SPSS v23. Results 597 patients met inclusion criteria. 93% female, mean age 58.5±12.4 years, mean disease duration 7.5 years. HT 73.9% (441), DM 14.2% (85), dyslipidemia 21.3% (127), obesity 17.9% (107), smoking 9.9% (59), high ESR 60.0% (358), high CRP 49.7% (297), scDMARD8 2.7% (494), bDMARDS 36.8% (218), tsDMARDS 18.1 (108). Frequency of fatigue 19.9% (119): moderate 12.9% (77), severe 7.0% (42). Correlation of FACIT-F with DAS28, CDAI and HAQ-DI: No fatigue FACIT-F 80.1% (478): DAS28 remission or low activity 84.9% (406), CDAI remission or low activity 93.5% (447), moderate 4.0% (19), high activity 2.5% (12), HAQ-DI mild 75.9% (363), moderate 16.5% (79), severe 7.5% (36). Moderate FACIT-F 12.9% (77): DAS28 remission or low activity 19.5% (15), moderate 80.5% (62), CDAI moderate 48.1% (37), high activity 51.9% (40), HAQ-DI mild 24.7% (19), moderate 63.6% (49), severe 11.7% (9). Severe FACIT-F 7.0% (42): DAS28 remission or low activity 4.8% (2), high activity 95.2% (40), CDAI low activity or remission 35.7% (15), high activity 64.3% (27), HAQ-DI mild 7.1% (3), moderate 23.8% (10), severe 69.0% (29). Correlation between FACIT-F/DAS28 ( r p = .673, p&lt; .001) and FACIT-F/CDAI ( r p = .701, p &lt; .001) were strong. Conclusion The study showed a low frequency of fatigue; the degree of fatigue most found was moderate. The group of patients with fatigue had a statistically significant linear association with disease activity and degree of functional limitation. There were no patients with extreme fatigue. References [1]Gomero García, D., 2018. Rheumatoid arthritis, epidemiology, pathophysiology, diagnostic criteria and treatment. Journal of Medicine and Research Universidad Autónoma del Estado de México, 6(2). [2]Wagan AA, Raheem A, Bhatti A, Zafar T. Fatigue assessment by FACIT-F scale in Pakistani cohort with Rheumatoid Arthritis (FAF-RA) study. Pak J Med Sci. 2021;37(4). [3]Hammam N, Gamal RM, Rashed AM, Elfetoh NA, Mosad E, Khedr EM. Fatigue in Rheumatoid Arthritis Patients: Association With Sleep Quality, Mood Status, and Disease Activity. Rheumatol Clin (Engl Ed). 2020 Sep-Oct;16(5 Pt 1):339-344. [4]James K, Al-Ali S, Tarn J, Cockell SJ, Gillespie CS, Hindmarsh V, et al. (2015) A Transcriptional Signature of Fatigue Derived from Patients with Primary Sjögren’s Syndrome. PLoS ONE. [5]Cella D. The Functional Assessment of Cancer Therapy-Anemia (FACT-An) Scale: a new tool for the assessment of outcomes in cancer anemia and fatigue. Semin Hematol. 1997 Jul;34(3 Suppl 2):13-9. Disclosure of Interests None declared